Different Funding Modalities for Health – Update

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This is an update of a 2011 report, which looked at evidence for the benefits of providing health funding support through sector budget support(SBS) as opposed to disease specific funds or programmes. It also investigates whether specific outcomes can be attributed to different funding modalities.


Key findings include:

  • Sector budget support has generated some impressive results in the health field in the East Africa context.
  • General budget support (GBS) increases the budget allocation for the health sector more than tax revenue does. However, the effect of government health expenditure on health indicators is not necessarily improved by the introduction of GBS, which indicates that the introduction of GBS alone has limited impact.
  • GBS recipients have performed better in MDGs as well as in terms of improvements in the Human Development Index, in the period 2002-2007.
  • SBS has generally helped support the expansion of service delivery, through financing a major share of service delivery inputs, though has not effectively addressed the quality of service delivery.
  • An ODI evaluation  shows negative effects on resource allocation of switching from GBS to a Health SWAp.
  • World Bank research finds positive impact for results-based financing.
  • A Particip GmBH evaluation tries to assess different aid modalities used by the European Commission (EC) to the health sector and notes that actual attribution is difficult. EC SBS was found to contribute significantly to financing staff retention schemes, but data available do not permit a precise statement of impact.


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